1. Field of the Invention
The invention relates in general to computer-based tools for aiding in business and financial decision-making, and in particular to a novel system for aiding a physician or other interested party in making decisions relating to contracts between health care payers and physician contractors or other health care providers.
2. Background and Related Art
Capitated health care is rapidly gaining market acceptance in many geographical areas. This environment raises many decisional challenges for the physician and administrators in the medical care field. In particular, physicians and medical practice administrators entering into capitated contracts have had difficulty in balancing the often-conflicting goals of maintaining standards of quality in health care delivery and maintaining adequate practice revenue. One of the principal difficulties encountered in this regard has been the lack of an accurate means for comparing revenues generated under an at-risk contract with those generated under a traditional fee-for-service arrangement. Specifically, difficulty has arisen in understanding the interactions between an amount paid under a capitated contract, the utilization of services under the contract, and the resulting revenue earned in delivering those services.